Yasutoshi Ohta MD, Presenter: Nothing to Disclose

Hiroto Yunaga, Abstract Co-Author: Nothing to Disclose

Yasuhiro Kaetsu, Abstract Co-Author: Nothing to Disclose

Tomomi Watanabe MD, Abstract Co-Author: Nothing to Disclose

Shinichiro Kitao, Abstract Co-Author: Nothing to Disclose

Yoshiyuki Furuse, Abstract Co-Author: Nothing to Disclose

Kazuhiro Yamamoto, Abstract Co-Author: Nothing to Disclose

Toshihide Ogawa MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to compare the calcification surpressed MD image with the conventional virtual monochromatic single energy CT image (VMSECT) on diagnostic performance for detecting obstructive coronary artery disease (CAD) with calcification.

Sixty-nine consecutive patients suspected or known CAD prospectively underwent DECT (Discovery CT750HD, freedom edition, GE) using rapid kV switching dual energy scan (80kV, 140kV, 600mA) before elective invasive coronary angiography (ICA). MD images (Iodine density with hydroxyapatite suppression) were generated on a workstation. Coronary artery stenosis was evaluated qualitatively by MD image and conventional CTA image using VMSECT independently. Cross-sectional arc calcium was evaluated and rated on a segment model as follows: non-calcified, mild, moderate, and severe calcification. The diagnostic performance of two methods for detecting CAD (>50% luminal diameter stenosis) was compared with ICA as reference standard.

A total of 440 segments containing mild (139, 32%), moderate (69, 16%), and severe (31, 7%) calcification were detected and evaluated. For all calcified segments, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to detect >=50% stenosis were 88%, 88%, 75%, and 94%, respectively for MD image and 91%, 71%, 56%, and 95%, respectively for VMSECT image. The PPV significantly improved on MD image (p<0.05). A significant difference was found in the receiver-operating characteristic curves between MD image and VMSECT image (0.92 vs. 0.87, p=0.012).

The diagnostic performance of MD image using DECT for calcified coronary lesions was superior to VMSECT. MD image by DECT with higher PPV is suited to detect and rule out the presence of significant CAD with calcification.

Calcium suppressed coronary CTA in material density (MD) image using rapid kV switching dual energy CT (DECT) improves diagnostic performance for detecting calcified obstructive coronary artery disease.

Ohta, Y, Yunaga, H, Kaetsu, Y, Watanabe, T, Kitao, S, Furuse, Y, Yamamoto, K, Ogawa, T, The Diagnostic Performance of Calcification Suppressed Coronary CT Angiography Using Rapid kV Switching Dual Energy CT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005279.html